The day I did everything I shouldn't...

I actually had a different blog post planned for today, but it turns out I did everything a medical professional the world over ***should not do.***

Before I get into the specifics though, let me just say that I had good reasons on both counts... but you can judge for yourselves. 

Case 1: 

Remember Taira, the little boy I mentioned earlier with the femur fracture? Well, he was doing great, we had him up and walking, he got crutches and was basically ready to come home. That's him, with me and Will, the first day we got him up. 

Except today during dressing changes, pus started pouring out of his leg. Not much, but enough to show it was infected. Surprise, surprise. So Dr. Scott took him back to the OR to open it up and clean it out... 

I walk in the OR when they're prepping him, and there are two nurses, one on each arm, trying to start an IV. Admittedly, I don't know much, but I do know how to start an IV. And I know that on an 11-year-old boy, you don't take a large IV needle. We have pediatric needles for that. They were poking the boy full of holes, starting in the ante-cubital fossa and moving toward the hand, not missing the veins, but exploding them because the needles were too big. 

At one point, one of them sets a needle on the counter, repositions the stopper, and picks it up again. That was my limit. I jumped in and yelled out "No! Stop! You just can't do that! You can't keep using the same needle over and over again! And why are you using such large gauge needles and exploding this kid's veins??" 

He turns to me and says "if we get new needles, they have to pay for them again..." so I said "Fine! I'll pay for it then!" 

Stormed out of the OR, bought pediatric needles, came back and gave it to them. Sure enough, they got it in the first try without exploding the kid's veins... And I yelled at them again for not using smaller needles to begin with!

Case 2:

There's a little girl (about 3 years old) whose dad is a patient. I have already won her over and she smiles and shakes my hand. A couple of days ago, her dad told me she wasn't feeling well. This morning I asked about her, and he tells me mom had taken her to the city hospital. This afternoon I go over to the ward and she's sitting there on mom's lap, struggling to breathe... 

Now, there are a lot of little kids who come in with one foot in the grave, mostly malaria, and I have made the decision that I would stay away from them. They come in so advanced, that try as we may, most of them die...so I didn't want to have my heart torn out time and again, kid after kid. Call me a coward if you will, but I know my limits. 

However, this little girl, I know her. I saw her healthy and playing. I know her name, I talk to her parents every day, and I would see her just deteriorate and die. No way. 

So again, I jumped in and told her dad to get her in to the consult that I would be responsible (financially) for anything she needed. 

She is now on IV quinine and blood (she was severely anemic) and hospitalized right next to her dad. She should be ok, because she wasn't on death's doorstep yet. One more day, and she probably would have been. 

So there you have it. I broke all the rules. I pissed off the nurses and got too involved with my patients. 

I dare you to come over here and do anything different. 

Little black children and big nasara people

To say there are cultural differences between Chad and everywhere else I have ever lived is a gross understatement. 

One of the things I learned on my first afternoon here was that most children are TERRIFIED of white people. The parents tell them that if they're bad, the white people will come get them and drink their blood... so they see us coming and literally start screaming. 

This was sad for me, because I love kids, and usually, kids love me too. 

When they start getting older, they start losing fear, probably because they realize we're not really going to drink their blood. 

Anyway, so there's this boy, who is about 10 or 11. The first day I saw him, he looked at me with big, scared eyes, answered my questions with yes or no, and seemed anxious for me to leave. He had a femur fracture as you can clearly see in the x-ray below: 

On Sunday, I asked his name, and he told me: Taira. 

Monday morning comes along, I walked into the room, looked at him and said "Bonjour Taira!" and man, oh man! His face lit up like a Christmas tree. He smiled so big, I almost cried. So I went and talked to him, then his mom came and talked to me too, and asked me questions about his operation, which would be on Tuesday. 

Yesterday I got to spend the entire day in the OR. Dr. Scott plated and fixed his femur, and it looked amazing!! 

However, like I mentioned earlier, the patients are awake during surgery. There's a drape covering the surgical area, but they can still see the Anesthetist moving around, injecting things into their arms, etc. They can also hear everything we say. The kid was terrified. He was shaking with fear... So I went there and started talking to him, held his hand, told him it would be ok, just tried to calm him down...

He now knows my name, smiles everytime I'm around, and his mom also really likes me. He has two younger sisters, and although they're still keeping a safe distance, they have started to smile as well. I will still win them over! :)

Yesterday was a great day... I will share more stories and photos later... :) now it's time for bed! 

P.S.: For those of you who were wondering, my amputee lady is still alive. She developped a fever last night, so we started her on malaria treatment (they all have it, as they don't have mosquito nets or repellent) and she was better this morning. Her wound is still infected, but we're keeping the abcess open and it actually looks ok... 

Please keep her, Taira and all the other patients in your prayers... And again, if you can help, please do!!! http://www.ahiglobal.org/main/donate-now/

(Don't forget to specify that it's for "Centre Chirurgical de Moundou, Chad).